No More Monkeys...

The American Academy of Pediatrics has just published its policy statement, "Trampoline Safety in Childhood and Adolescence" (Pediatrics 2012;130:774-9). It cites the most recent injury figures in 2009 of 70 per 100,000 for children aged 0 to 4 years and 160 per 100,000 for 5- to 14-year-olds. The statement also raises concerns about the quality of the equipment as lower-priced backyard models have entered the market. Padding on the frames of the higher-priced trampolines still seems to be ineffective in preventing injuries.

When there are multiple jumpers on the trampoline, the risk of injury increases dramatically. And, while the safety of most recreational activities seems to significantly improve with adult supervision, this doesn’t seem to be the case with trampolines. Between a third and a half of all trampoline injuries occurred during adult supervision.

The AAP’s statement stops short of suggesting that all trampolines be dismantled and recycled into lawn furniture. But it does leave the impression that allowing a child to play on a trampoline is a bad idea.

My personal relationship with trampolines ended with high school. Because I had some competitive diving experience, I was asked to do a demonstration during halftime of the faculty-varsity basketball game. My final trick was a backward somersault that ended poorly with me cradled in the arms of one of the spotters. The announcer, who was also the football coach, bellowed, "Bill (I now go by Will) is going to climb back up and do it again." Although this wasn’t my plan, I desperately wanted to make the starting 11 in the fall. While I can’t say I stuck the landing, at least I ended up closer to the center of the trampoline.

My professional experience with trampolines has been even more limited and certainly less exciting. I have seen very few trampoline-related injuries in children, and fortunately none have been serious or memorable. I suspect there are several factors at play here. Our geographic isolation in Maine means that most fads arrive here late or not at all. I can’t recall seeing a single outdoor trampoline park. Our long cold winters discourage the purchase of trampolines and swimming pools. However, we do have them.

While trampolines may not generate an alarming number of injuries here in Brunswick, I can tell you that mattresses do. At least once a month we see a child who was injured bouncing on (or often off) a bed. Most of these injuries are of the superficial hematoma, split lip, chipped tooth variety. But a significant number are not so trivial. My personal list includes one ruptured spleen, one fractured femur, a couple of tibial fractures, a few handfuls of broken clavicles, and a dozen or more mild concussions.

A quick Internet search yielded no studies of the incidence and severity of bed-bouncing injuries. But I’m sure my experience is not unique. I inspected the tag on my mattress (the one that if you tear it off you go to federal prison), and it does not include a warning about bed jumping.

While I applaud the AAP for making its current statement on trampoline safety, it may be time to form a working group tasked with addressing the issue of bed bouncing. Currently, the sum total of our prevention effort on this risky behavior comes in the form of a nursery rhyme.

Recite along with me:

One little monkey jumping on the bed.

He fell off and bumped his head.

Mama called the doctor and the doctor said,

"No more monkeys jumping on the bed!"

As a start, we should include this admonition on every mattress tag.

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine. E-mail him at [email protected].

The American Academy of Pediatrics has just published its policy statement, "Trampoline Safety in Childhood and Adolescence" (Pediatrics 2012;130:774-9). It cites the most recent injury figures in 2009 of 70 per 100,000 for children aged 0 to 4 years and 160 per 100,000 for 5- to 14-year-olds. The statement also raises concerns about the quality of the equipment as lower-priced backyard models have entered the market. Padding on the frames of the higher-priced trampolines still seems to be ineffective in preventing injuries.

When there are multiple jumpers on the trampoline, the risk of injury increases dramatically. And, while the safety of most recreational activities seems to significantly improve with adult supervision, this doesn’t seem to be the case with trampolines. Between a third and a half of all trampoline injuries occurred during adult supervision.

The AAP’s statement stops short of suggesting that all trampolines be dismantled and recycled into lawn furniture. But it does leave the impression that allowing a child to play on a trampoline is a bad idea.

My personal relationship with trampolines ended with high school. Because I had some competitive diving experience, I was asked to do a demonstration during halftime of the faculty-varsity basketball game. My final trick was a backward somersault that ended poorly with me cradled in the arms of one of the spotters. The announcer, who was also the football coach, bellowed, "Bill (I now go by Will) is going to climb back up and do it again." Although this wasn’t my plan, I desperately wanted to make the starting 11 in the fall. While I can’t say I stuck the landing, at least I ended up closer to the center of the trampoline.

My professional experience with trampolines has been even more limited and certainly less exciting. I have seen very few trampoline-related injuries in children, and fortunately none have been serious or memorable. I suspect there are several factors at play here. Our geographic isolation in Maine means that most fads arrive here late or not at all. I can’t recall seeing a single outdoor trampoline park. Our long cold winters discourage the purchase of trampolines and swimming pools. However, we do have them.

While trampolines may not generate an alarming number of injuries here in Brunswick, I can tell you that mattresses do. At least once a month we see a child who was injured bouncing on (or often off) a bed. Most of these injuries are of the superficial hematoma, split lip, chipped tooth variety. But a significant number are not so trivial. My personal list includes one ruptured spleen, one fractured femur, a couple of tibial fractures, a few handfuls of broken clavicles, and a dozen or more mild concussions.

A quick Internet search yielded no studies of the incidence and severity of bed-bouncing injuries. But I’m sure my experience is not unique. I inspected the tag on my mattress (the one that if you tear it off you go to federal prison), and it does not include a warning about bed jumping.

While I applaud the AAP for making its current statement on trampoline safety, it may be time to form a working group tasked with addressing the issue of bed bouncing. Currently, the sum total of our prevention effort on this risky behavior comes in the form of a nursery rhyme.

Recite along with me:

One little monkey jumping on the bed.

He fell off and bumped his head.

Mama called the doctor and the doctor said,

"No more monkeys jumping on the bed!"

As a start, we should include this admonition on every mattress tag.

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine. E-mail him at [email protected].

The American Academy of Pediatrics has just published its policy statement, "Trampoline Safety in Childhood and Adolescence" (Pediatrics 2012;130:774-9). It cites the most recent injury figures in 2009 of 70 per 100,000 for children aged 0 to 4 years and 160 per 100,000 for 5- to 14-year-olds. The statement also raises concerns about the quality of the equipment as lower-priced backyard models have entered the market. Padding on the frames of the higher-priced trampolines still seems to be ineffective in preventing injuries.

When there are multiple jumpers on the trampoline, the risk of injury increases dramatically. And, while the safety of most recreational activities seems to significantly improve with adult supervision, this doesn’t seem to be the case with trampolines. Between a third and a half of all trampoline injuries occurred during adult supervision.

The AAP’s statement stops short of suggesting that all trampolines be dismantled and recycled into lawn furniture. But it does leave the impression that allowing a child to play on a trampoline is a bad idea.

My personal relationship with trampolines ended with high school. Because I had some competitive diving experience, I was asked to do a demonstration during halftime of the faculty-varsity basketball game. My final trick was a backward somersault that ended poorly with me cradled in the arms of one of the spotters. The announcer, who was also the football coach, bellowed, "Bill (I now go by Will) is going to climb back up and do it again." Although this wasn’t my plan, I desperately wanted to make the starting 11 in the fall. While I can’t say I stuck the landing, at least I ended up closer to the center of the trampoline.

My professional experience with trampolines has been even more limited and certainly less exciting. I have seen very few trampoline-related injuries in children, and fortunately none have been serious or memorable. I suspect there are several factors at play here. Our geographic isolation in Maine means that most fads arrive here late or not at all. I can’t recall seeing a single outdoor trampoline park. Our long cold winters discourage the purchase of trampolines and swimming pools. However, we do have them.

While trampolines may not generate an alarming number of injuries here in Brunswick, I can tell you that mattresses do. At least once a month we see a child who was injured bouncing on (or often off) a bed. Most of these injuries are of the superficial hematoma, split lip, chipped tooth variety. But a significant number are not so trivial. My personal list includes one ruptured spleen, one fractured femur, a couple of tibial fractures, a few handfuls of broken clavicles, and a dozen or more mild concussions.

A quick Internet search yielded no studies of the incidence and severity of bed-bouncing injuries. But I’m sure my experience is not unique. I inspected the tag on my mattress (the one that if you tear it off you go to federal prison), and it does not include a warning about bed jumping.

While I applaud the AAP for making its current statement on trampoline safety, it may be time to form a working group tasked with addressing the issue of bed bouncing. Currently, the sum total of our prevention effort on this risky behavior comes in the form of a nursery rhyme.

Recite along with me:

One little monkey jumping on the bed.

He fell off and bumped his head.

Mama called the doctor and the doctor said,

"No more monkeys jumping on the bed!"

As a start, we should include this admonition on every mattress tag.

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine. E-mail him at [email protected].